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只要自闭症的诊断是基于行为的,就只能事后做出明确的申明。也许一旦有了生物检测,就可以在出生前做出诊断,但这样的检测似乎还遥遥无期。必须依赖行为准则意味着不得不接受模棱两可的生活。而且,由于所有儿童之间的差异如此之大,即使是经验丰富的临床医生也会在过早地要求作出明确声明的压力下做出错误判断。
What happens when parents seek professional help, when the social and emotional development of their child seems to deteriorate or simply not move on? In the past there has often been a long and sometimes harrowing road, but now health professionals are more knowledgeable about autistic disorders and highly aware of the need for early intervention. Ideally, an experienced clinician will interview the parents about their child’s development in detail, and will also test and observe the child. Then provision can be made for a programme of special education to start right away. For this reason it is important that this diagnosis is done as early as possible.
当父母发现他们的孩子的社会和情感发展似乎恶化或根本没有继续前进,而寻求专业建议时会发生什么?在过去,常常有一个漫长的,有时是悲惨的道路,但现在的卫生专业人员更了解自闭症障碍,也高度意识到需要早期干预。理想情况下,有经验的临床医生会非常详细的向父母询问孩子的发育细节,也会对孩子进行测试和观察。然后,就可以为立即开始提供特殊教育计划预案。因此,尽早进行诊断是很重要的。
However, there is a dilemma. Researchers asked the question: if a child is diagnosed at the age of 24 months, how certain is the diagnosis? Researchers investigated how likely it is that the diagnosis is confirmed two years later. They showed that in the majority of cases the diagnosis was indeed confirmed, but still one-third of the cases were eventually not considered autistic. The study also showed that there is almost complete certainty about the diagnosis when the child is older than 30 months.
然而,这是一个两难的选择。研究人员提出了一个问题:如果一个孩子在24个月大时被诊断出自闭症,那么这个诊断确定程度有多大?结果显示,大多数病例的诊断确实得到了证实,但仍有三分之一的病例最终没有被认为是自闭症。研究还表明,当孩子超过30个月大时,诊断几乎完全确定。